Joint CBC-ICT Interpretation for the pre-surgical screening of COVID 19 asymptomatic cases: A cross-sectional study

  1. Tanzeel Imran
  2. Humera Altaf Naz
  3. Hamza Khan
  4. Ali Haider Bangash
  5. Laraib Bakhtiar Khan
  6. Haroon Khan

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Abstract

Background

On 26 th , February 2020, first cases of COVID 19 were confirmed in Pakistan. Since then, surgeries were halted in a bid to prevent transmission. However, since such a long halt is infeasible, a general protocol of screening the carriers, especially asymptomatic carries, is a dire need of time. The objective of our study is to propose an economically feasible protocol of COVID 19 screening. Simple but effective screening strategies can help to restore the workings of hospital surgical departments.

Methods

We analyzed the clinical data of patients turning up for elective surgeries at the Rawal General Hospital (RGH), Islamabad from the 24 th of March to the 15 th of May, 2020. Asymptomatic patients with negative COVID 19 contact and travel histories were screened with COVID 19 Immunochromatography (ICT) IgM / IgG Ab Test. Complete blood count (CBC) was done and interpreted in conjunction with the ICT results.

Results

39 patients with a mean age of 49 years were studied. The result of ICT for COVID-19 was positive in 9 cases (23%). The entire positive ICT patients population expressed significantly lower lymphocyte count (p<0.01); 8 patients had high monocyte count (p<0.05) whereas only 4 patients had a combined high neutrophil and monocyte count (P<0.05). All of these four patients with high neutrophil count were females. The combined interpretation of CBC and ICT IgM / IgG Ab Test had a high accuracy in diagnosing asymptomatic COVID-19 carriers that were later confirmed by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR).

Conclusion

We propose that joint CBC-ICT interpretation should be adopted on a large scale to help in the diagnoses of asymptomatic carriers as both tests are simple and inexpensive and thus suit the developing countries’ limited health budget. Future research projects should be adopted in order to assess the accuracy of the proposed protocol on a large scale.

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  1. Version published to 10.1101/2020.07.16.20138354v2 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2020.07.16.20138354: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: All of the patients signed a consent form approved by the RGH Ethics committee for COVID 19 ICT IgM and IgG Ab Test in conjunction with CBC test.
    IRB: All of the patients signed a consent form approved by the RGH Ethics committee for COVID 19 ICT IgM and IgG Ab Test in conjunction with CBC test.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Anti-human IgG / IgM monoclonal antibodies along with anti-goat IgG polyclonal antibodies were used in the ICT kit manufactured by Core Technology CO.LTD, China.
    Anti-human IgG
    suggested: None
    anti-goat IgG
    suggested: None
    Software and Algorithms
    SentencesResources
    Statistical analysis was done by SPSS version 22.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.07.16.20138354v1 on medRxiv